四川轻化工大学学报(社会科学版)

中国社会医疗保险制度在实施过程中存在何种再分配效应，成为社会各界普遍关注的热点。在社会医疗保险制度基本实现全覆盖、社会医疗保险基金支出持续上升以及商业医疗保险规模不断扩大的背景下，选取中国家庭金融调查数据（CHFS），通过估算社会医疗保险制度实施前后的收入不平衡指标，分析社会医疗保险的收入再分配效应。在此基础上，对社会医疗保险的作用机制、服务可及性、城乡差异性以及动态变化趋势进行分析。结果表明：社会医疗保险制度存在“倾贫”属性，可以降低居民收入差距，而商业医疗保险制度具有“利富”倾向；社会医疗保险更有利于低收入群体提高医疗服务的可及性，可以有效缓解低收入群体健康不平等导致的收入不平衡问题。同时，根据研究结论提出加快社会医疗保险基金补偿制度改革、促进中国不同分类医疗保险整合以及推进商业医疗保险健康有序发展等政策建议。

The redistribution effect of China′s social medical insurance system in the implementation process has become a hot topic of concern for all sectors of society. Against the backdrop of the basic full coverage of the social medical insurance system, the continuous increase in social medical insurance fund expenditures, and the continuous expansion of commercial medical insurance scale, China Household Finance Survey data(CHFS) is selected to estimate the income imbalance indicators before and after the implementation of the social medical insurance system, and analyze the income redistribution effect of social medical insurance. On this basis, the paper analyzes the mechanism of social medical insurance, service accessibility, urban-rural differences, and dynamic trends. The results indicate that the social medical insurance system has a "poverty leaning" attribute, which can reduce the income gap among residents, while the commercial medical insurance system has a "wealth benefiting" tendency. Social medical insurance is more conducive to improving the accessibility of medical services for low-income groups, and can effectively alleviate income inequality caused by health inequality among low-income groups. At the same time, policy recommendations are proposed, based on research conclusions, to accelerate the reform of the social medical insurance fund compensation system,promote the integration of different types of medical insurance in China, and promote the healthy and orderly development of commercial medical insurance.